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COVID-19 hospitalization linked to greater long-term health risks than seasonal influenza

A study published in The Lancet Infectious Diseases reveals that the long-term risk of death and health adversities related to coronavirus disease 2019 (COVID-19)-related hospitalization is higher than that related to seasonal influenza-related hospitalization.



Study: Long-term outcomes following hospital admission for COVID-19 versus seasonal influenza: a cohort study. Image Credit: Andrii Vodolazhskyi / Shutterstock

Background

Like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of probably the most recent COVID-19 pandemic, influenza viruses are enveloped RNA viruses that cause mild to severe respiratory infections. Each COVID-19 and influenza are related to the next risk of antagonistic health outcomes and mortality.

Previous studies comparing health outcomes between hospitalized COVID-19 and influenza patients exhibit that SARS-CoV-2 infection is related to the next risk of death and long-term health adversities than seasonal influenza infection as much as six months following infection.

On this study, scientists have investigated each acute and long-term risks of death, healthcare utilization, and a comprehensive set of 94 health outcomes over a period of 18 months in patients who were admitted to the hospitals as a consequence of COVID-19 or seasonal influenza.

Study design

The study population included 81,280 COVID-19 patients admitted to the hospital between 2020 and 2022 and 10,985 seasonal influenza patients hospitalized between 2015 and 2019. The patient data were obtained from the US Department of Veterans Affairs healthcare databases. The patients were followed up for 18 months.

The parameters assessed within the study included acute and long-term risks and burdens of death, a comprehensive set of 94 health outcomes, ten organ systems, overall burden across all organ systems, hospital readmission, and admission to the intensive care unit (ICU). Furthermore, disability-adjusted life-years (DALYs) per 100 individuals were estimated using appropriate statistical methods. The risks were evaluated at 30 days, 180 days, 360 days, and 540 days after hospital admission.    

Vital observations

The study found the next absolute mortality rate amongst hospitalized COVID-19 patients than hospitalized seasonal influenza patients at each tested time point. Specifically, COVID-19 was related to an excess mortality rate of 8.62 per 100 individuals in comparison with influenza infection at 540 days post-hospitalization.

During your complete 540-day follow-up period, COVID-19 patients showed a significantly increased risk of 64 out of 94 examined health outcomes, including cardiovascular, coagulation and hematological, fatigue, gastrointestinal, kidney, mental health, metabolic, musculoskeletal, neurological, and pulmonary outcomes.  

In contrast, patients with influenza infection showed an increased risk of six health outcomes, including chest pain, increased heart rate, type 1 diabetes, and three of 4 pulmonary outcomes (cough, hypoxemia, and shortness of breath).

Considering health adversities across all organ systems, COVID-19 was related to an excess rate of 78.7 per 100 individuals in comparison with influenza infection during your complete follow-up period. Furthermore, COVID-19 was related to the next disability-adjusted life years of 45.03 per 100 individuals in comparison with influenza infection.    

Considering acute and long-term health outcomes, greater than 50% of COVID-19- and influenza-related adversities in all examined organ systems apart from the gastrointestinal system occurred within the post-acute phase of infection. Nonetheless, COVID-19 patients showed comparatively higher adversities in all organs apart from the pulmonary system in each acute and post-acute phases of infection.

In comparison with patients with influenza, COVID-19 patients showed higher risks of hospital readmission and ICU admission in any respect tested time points.

Throughout the pre-delta, delta, and omicron waves, COVID-19-related hospitalization was related to higher risks of mortality, health adversities across all organs apart from the pulmonary system, hospital readmission, and ICU admission in comparison with influenza-related hospitalization. Across all three pandemic waves, the disease burden was higher within the post-acute infection phase than within the acute phase.

The risks of mortality and health adversities as a consequence of COVID-19 remained higher than influenza-related risks whatever the patients’ COVID-19 and influenza vaccination status.

Study significance

The study finds that hospitalized COVID-19 patients have higher long-term risks of mortality, health adversity, and healthcare utilization than hospitalized influenza patients. In comparison with influenza, COVID-19 is related to the next risk of health adversities in nearly all organs except the pulmonary system. Furthermore, COVID-19 hospitalization is related to higher disability-adjusted life years in comparison with influenza hospitalization.

As mentioned by the scientists, long-term health outcomes of patients with influenza or SARS-CoV-2 infection must be fastidiously monitored in an effort to prevent health adversities and reduce mortality risk.

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